Jackson, Keven

Jackson, Keven was paid $4K by Medicaid between Aug 2019 and Sep 2022, across 3 billing codes. Its largest line is D0120, dental checkup, returning patient — 55% of everything it billed.

33Billing provider infoJACKSON, KEVEN
CAMBRIA HEIGHTS, NY 11411

33aNPI1932294006assigned 10/04/2006

33bProvider typeDentist

28Total paid$4K

24GClaims157

24DCodes billed3

24AFirst – last monthAug 2019 – Sep 2022

Compared with peers

Next to other Dentist providers in New York

Rank by total paid#1,341 of 1,649

Median peer was paid$49K

This provider vs. median0.1×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2019	15	$292.23
2020	52	$866.34
2021	63	$2K
2022	27	$731.50

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	55%	101	101	$2K
D1110	Prophylaxis - adult	43%	44	44	$2K
D1208	Topical application of fluoride, excluding varnish	2.2%	12	12	$78.40

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.